History

MDMA (chemical name 3,4-methylenedioxymethamphetamine), also known as Ecstasy, is an illegal psychedelic and stimulant drug most commonly known for inducing an energized and euphoric state in its users. Like many other psychedelic drugs, MDMA can alter the user’s sense of time, perception, and can even enhance tactile experiences. MDMA was discovered while underground chemists were trying to synthesize alternatives to the illegal drug MDA in 1970. Since psychiatrists found that the drug improved communication between clinicians and their patients in therapeutic sessions, MDMA gained popularity in the 1970s. Despite this, MDMA was classified as a Schedule I drug in 1985, banning the drug entirely, and denying all therapeutic value. However, MDMA was officially approved by the U.S. Food and Drug Administration (FDA) for human experimentation under carefully monitored conditions for the treatment of post-traumatic stress disorder in the late 2000s.

How It’s Used

MDMA is most often distributed in tablet or capsule form, and taken orally. On average, users will take between 1 to 2 tablets which can contain anywhere from 60 to 120 milligrams of pure MDMA, with effects lasting approximately 3 to 6 hours. As tolerance builds, users will often increase their dose, in an attempt to maintain the positive effects of the drug. In actuality, users become more likely to experience some of the negative effects of MDMA, such as increased anxiety, agitation, and dehydration. Due in part to the popularity of ecstasy as a club drug, tablets very rarely consist of pure MDMA. As such, users can easily be exposed to other harmful drugs that are used in the process of mass-producing this drug. Other harmful substances found in ecstasy tablets can include methamphetamine, cocaine, caffeine, ephedrine, over-the-counter cough suppressant dextromethorphan, and/or bath salts. Even so-called “molecular” MDMA, or “Molly” often contains these contaminants. In addition, users commonly mix MDMA with other substances, such as alcohol or marijuana, which can increase the dangers associated with dehydration and overheating in a crowded club setting.

How It Works

MDMA primarily acts by enhancing the activity of the neurotransmitter serotonin. Serotonin is involved in mood and perception, so the effects of ecstasy largely target those processes. Users typically report enhanced sensory perception, interpersonal closeness, empathy, and a general sense of wellbeing. Ecstasy can also cause increases in heart rate, blood pressure, and body temperature by acting on the norepinephrine system. Although the positive effects of MDMA use seem appealing, there are several adverse health risks that can potentially lead to long-term damage. By acting as a stimulant, MDMA allows for sudden increases in psychical energy. Because of this, users run the risk of experiencing hyperthermia, dehydration, hypertension, and heart failure due to the sudden increases in body temperature and heart rate MDMA induces. Ecstasy can also induce nausea, body chills, sweating, involuntary teeth clenching, muscle cramping, and blurred vision. Users also run the risk of overdose, which can include high blood pressure, faintness, panic attacks, or even seizures and loss of consciousness.

Aside from the physiological effects, MDMA use also induces a series of psychological effects which can last for hours after taking the drug. Most changes affect the user’s memory and thus, significant reductions in mental abilities are seen for up to a week. These can become severe after long-term regular use. Most commonly reported symptoms following moderate MDMA use include feelings of anxiety, restlessness, irritability, sadness, clinical depression, impulsiveness, and aggression. Chronic users also report unpleasant changes in sleep, appetite, and sex drive.

Treatment

Animal studies show robust self-administration behavior for MDMA, indicating MDMA has some addictive potential. However, when compared to other addictive substances such as methamphetamine or cocaine, the degree at which animals self-administer MDMA is much lower. Short term treatment for MDMA intoxication can treat the physical effects of the drug and prevent the risk of dehydration and overheating. No specific long-term treatment for MDMA abuse is known. Thus, clinicians rarely rely upon pharmacological treatments unless MDMA use further exacerbates symptoms such as depression in susceptible users. Instead, cognitive behavioral interventions, as well as support groups tend to be the most effective in treating MDMA abuse. These interventions are highly effective, as they promote thought and behavior modification, as well as the utilization of various coping strategies when dealing with common life stressors.